TAX ORGANIZER Page Basic Taxpayer Information Taxpayer Spouse Taxpayer Spouse First Name Initial Last Name Social Security No. Check if Date of Occupation Dependent Presidential Birth Disabled Blind of Another Election Contrib. X Street Address Phone Res: City, State & Zip Phone Work: School District Filing Status - Single; - Married filing joint; - Married filing separate; - Head of Household; - Qualifying Widower Dependent Information Name (first, initial, and last name) Date of Birth Social Sec. No. Relationship Months in home Wages and Salaries Employer Name Wages Federal FICA Medicare State Local Tax Tax Withheld Withheld Withheld Tax Withheld Withheld Interest Income Source Amount Source 7 7 8 8 9 9 0 0 Dividend Income Ordinary Amount Qualified Amount
Gains or Losses from Sales of Stocks, Securities or Other Assets Page 7 8 9 0 7 8 9 0 Kind of Property and Description Date acquired Date sold Sales Price Cost or other basis Other Income Taxable refunds of state and local income taxes Alimony received Business income or (loss) - Schedule C Other gains or (losses) - Form 797 Total IRA distributions Total pensions and annuities 7 Rents and royalties, trusts, S corporations, partnerships - Schedule E 8 Farm income or (loss) - Schedule F 9 Unemployment compensation 0 Total social security benefits Tips Child care taxable benefits Prizes and awards Scholarships and fellowships All other income not provided for in this organizer Educator expenses Business expenses Your IRA deduction Spouse's IRA deduction Student loan interest Tuition and fees deduction 7 Health savings account deduction 8 Moving expenses 9 Self-employed SEP, SIMPLE, and qualified plans 0 Penalty on early withdrawal of savings Alimony paid Adjustments to Income Prior Year Current Year Current Year Amount Taxpayer Spouse Prior Year Current Year Current Year Amount Taxpayer Spouse
Page Itemized Deductions a Medical and dental expenses (other than long-term care premiums) b Long-term care premiums Taxpayer Spouse Real estate taxes Personal property taxes Other taxes Home mortgage interest and points reported on Form 098 Home mortgage interest not reported on Form 098 Name: Address: SSN: 7 Home mortgage points not reported on Form 098 8 Investment interest paid 9 Gifts to charity by cash or check 0 Gifts to charity other than by cash or check Mileage driven to charitable activities Casualty and theft losses - Form 8 Unreimbursed employee expenses Travel expenses (exclude meals) Meals and entertainment Parking and tolls (enter other vehicle information on Page 7) Telephone used for employer's business (allocate cost) Professional organization or union dues Educational expenses required to maintain your job Office in home required by employer Tools and equipment Safety and protective clothing Uniform costs Professional journals subscriptions Job seeking costs Other Other expenses Investment expenses Tax preparation fees Safe deposit box rental Other Other miscellaneous deductions Prior Year Amount Current Year Amount Child or Dependent Care Expenses Paid To Social Security Amount Name Address or ID Number Paid
Page Federal, State and Local or Other Estimated Taxes Paid Federal Estimates Overpayment from last year First quarter payment Second quarter payment Third quarter payment Fourth quarter payment 7 Enter Payment Information Filer and/or Joint Payments Spouse Only Payments Date Paid Amount Date Paid Amount State Estimates Enter two-letter state abbreviation State State State State Enter Payment Information Date Paid Amount Date Paid Amount Date Paid Amount Date Paid Amount Overpayment from last year First quarter payment Second quarter payment Third quarter payment Fourth quarter payment 7 8 Local or Other Estimates Enter description Desc Desc Desc Desc Enter Payment Information Date Paid Amount Date Paid Amount Date Paid Amount Date Paid Amount Overpayment from last year First quarter payment Second quarter payment Third quarter payment Fourth quarter payment 7 8
Vehicle Information and Expenses Description of vehicle Is the vehicle used in a business or by an employee? Cost (including sales tax) Date placed in service Business miles: January through August September through December Commuting miles (daily commuting miles times the number of trips to work) 7 Other personal use miles 8 Total miles driven 9 Gas and oil expenses 0 Repairs and maintenance Auto insurance Registration, licenses, and fees Other auto expenses (identify) Auto rentals Auto Mileage Documentation Is another car available for personal use? Do you have evidence to support your mileage information reported above? If "Yes," is the evidence written in a log or other place? 7 8 Income or Loss from S Corporations Name Income Loss Income or Loss from Partnerships Name Income Loss Income or Loss from Trusts Name Income Loss Vehicle One Other Expenses Other Expenses Other Expenses Page 7 Vehicle Two Yes No Passive (Yes / No) Passive (Yes / No) Passive (Yes / No)
Page 8 Self Employed Business Income and Expenses Name of business (A) Address of business (A) Name of business (B) Address of business (B) Business A Business B Prior Year Current Year Prior Year Current Year Gross receipts or sales Returns and allowances Inventory at beginning of year Cost of merchandise purchased 7 Cost of labor 8 Materials and supplies 9 Other costs 0 Inventory at end of year Advertising Car and truck expenses Commissions and fees Depletion Depreciation Employee benefit programs 7 Insurance (not health) 8 Mortgage interest 9 Other interest 0 Legal and professional services Office expense Pension and profit-sharing plans Rent or lease: machinery/equipment Rent or lease: other business property Repairs and maintenance Supplies 7 Taxes and licenses 8 Travel 9 Meals and entertainment 0 Utilities Wages Other: 7 8 9 New equipment purchases Date Did you trade-in any Was this financed? Description Purchased Cost equipment? Y/N If yes, enter amount
Page 9 Self Employed Business Income and Expenses Name of business (C) Address of business (C) Name of business (D) Address of business (D) Business C Business D Prior Year Current Year Prior Year Current Year Gross receipts or sales Returns and allowances Inventory at beginning of year Cost of merchandise purchased 7 Cost of labor 8 Materials and supplies 9 Other costs 0 Inventory at end of year Advertising Car and truck expenses Commissions and fees Depletion Depreciation Employee benefit programs 7 Insurance (not health) 8 Mortgage interest 9 Other interest 0 Legal and professional services Office expense Pension and profit-sharing plans Rent or lease: machinery/equipment Rent or lease: other business property Repairs and maintenance Supplies 7 Taxes and licenses 8 Travel 9 Meals and entertainment 0 Utilities Wages Other: 7 8 9 New equipment purchases Date Did you trade-in any Was this financed? Description Purchased Cost equipment? Y/N If yes, enter amount
Page 0 Profit or Loss from Farming Farm Activity A Farm Activity B Prior Year Current Year Prior Year Current Year Sales of livestock, produce, and grains Sales of livestock, produce, grains, and other products you raised Total cooperative distributions Agricultural program payments Commodity Credit Corporation (CCC) loans reported Taxable amount of CCC loans 7 Crop insurance proceeds 8 Custom hire (machine work) income 9 Other income 0 Car and truck expenses Chemicals Conservation expenses Custom hire (machine work) income 7 Depreciation 8 Employee benefit programs 9 Feed purchased 0 Fertilizers and lime Freight and trucking Gasoline, fuel, and oil Insurance (other than health) Mortgage interest Other interest Labor hired (less employment credits) 7 Pension and profit-sharing plans 8 Machinery rental or lease 9 Other rental or lease (land, animals, etc.) 0 Repairs and maintenance Seeds and plants purchased Storage and warehousing Supplies purchased Taxes Utilities Veterinary, breeding, and medicine 7 Other expenses Deductible Meals and Entertainment 8 9 0 New equipment purchases Date Did you trade-in any Was this financed? Description Purchased Cost equipment? Y/N If yes, enter amount
Page Income or Loss from Farm Rentals Farm Rental A Farm Rental B Prior Year Current Year Prior Year Current Year Income from production of livestock, produce, grains, and other crops Total cooperative distributions Agriculture Program Payments Commodity Credit Corporation (CCC) loans reported Taxable amount of CCC loans Crop insurance proceeds and other payments 7 Other Income Income from 099 MISC 8 9 0 Car and Truck Expenses Chemicals Conservation expenses Custom hire (machine work) Depreciation Employee benefit programs 7 Feed purchased 8 Fertilizers and lime 9 Freight and trucking 0 Gasoline, fuel, and oil Insurance (other than health) Mortgage interest (paid to banks, etc.) Other interest Labor hired (less employment credits) Pension and profit-sharing plans Rental or lease - Machinery 7 Rental or lease - Land 8 Repairs and maintenance 9 Seeds and plants purchased 0 Storage and warehousing Supplies purchased Taxes Utilities Veterinary, breeding, and medicine Other Expenses 7 8 9 0 New equipment purchases Date Did you trade-in any Was this financed? Description Purchased Cost equipment? Y/N If yes, enter amount
Page Income or Loss from Rentals and Royalties Properties - Address of Property Address of Property Address of Property Property Property Property Prior Year Current Year Prior Year Current Year Prior Year Current Year Was property used for personal purposes for more than the greater of days or 0% of the total days rented at fair rental value? Yes or No Yes or No Yes or No Total rents received Total royalties received Advertising expenses Auto and travel Cleaning & maintenance 7 Commissions 8 Insurance 9 Legal & professional fees 0 Management fees Mortgage interest paid Other interest Repairs Supplies Taxes Utilities 7 Other: 8 9 0 Expenses disallowed for vacation home Amortization New equipment purchases Date Did you trade-in Amount Finance Term Interest Description Purchased Cost any equipment? Financed (Months) Rate